M A Y 2 0 1 7 O U T P A T I E N TS U R G E R Y. N E T 4 9
antiseptic agent before the first
incision is an indispensable step
in preventing surgical site infec-
tions. We also know it takes time.
But the 30-second, back-and-forth
friction scrub at the incision site
is time well spent (plus, the
longer you prep, the better you're
able to reach the deeper skin lay-
ers). And waiting 3 minutes for
an alcohol-based prep to dry
before you drape not only helps
prevent surgical fires, especially
during electrosurgical cases.
Equally important is that it is the
amount of time that is required to
reduce the bacterial load on the
skin.
But there's more to prepping
the skin than just taking your
time. Technique is important, too. For example, you start a chlorhexidine glu-
conate scrub at the incision site and work your way out in concentric circles.
Once you've moved to the periphery, you don't want to reverse your clean-to-
dirty course and go back to the incision site, possibly spreading contaminants.
Another tactical consideration: How many prepping sticks do you need to cover
the body part you're prepping? You want neither too little (insufficient cover-
age) nor too much (pooling).
In late 2015, our frontline staff reported to us that we didn't always prep the site
according to the prep manufacturer's recommendation. (The fact that our nurses
• TIME WELL SPENT The skin prep impacts patient safety not only by reduc-
ing the risk of surgical site infections but also by preventing surgical fires.
Pamela
Bevelhymer,
RN,
BSN,
CNOR
